Provider Demographics
NPI:1720365356
Name:COCHRAN, MELISSA TRENICE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:TRENICE
Last Name:COCHRAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 13
Mailing Address - Street 2:
Mailing Address - City:CALDWELL
Mailing Address - State:AR
Mailing Address - Zip Code:72322-0013
Mailing Address - Country:US
Mailing Address - Phone:870-270-8100
Mailing Address - Fax:
Practice Address - Street 1:2110 N WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:FORREST CITY
Practice Address - State:AR
Practice Address - Zip Code:72335-1846
Practice Address - Country:US
Practice Address - Phone:870-630-9042
Practice Address - Fax:870-630-9589
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-10
Last Update Date:2011-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN11292183500000X
ARPD11559183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist